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Individual

SHELBY LOUISE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
7435 W TALCOTT AVE, CHICAGO, IL 60631-3707
(773) 990-7921
Mailing address
263 N JUBILEE CT, HAINESVILLE, IL 60073-4721
(509) 793-5428

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
125.083055
IL

Other

Enumeration date
04/06/2022
Last updated
08/28/2023
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